The effect of posture modification during continuous one-handed chest compression: A pilot study using in-hospital pediatric cardiac arrest simulation

Abstract

Background. We modified the posture of the one-handed chest compression (MOHCC) as follows: first, the axis of the rescuer's compression hand was adjusted to the lower half of the patient's sternum; second, the opposite hand was wrapped around the elbow joint of the rescuer's compression arm. This study evaluated the effect of the MOHCC on the mean chest compression depth (MCD) over time. Methods. Thirty medical doctors conducted 2 min of continuous MOHCC without ventilation using the in-hospital pediatric arrest model (70-cm-high bed, 25-cmhigh stepstool, a pediatric manikin and a cardiopulmonary resuscitation (CPR) meter). The MCD and mean chest compression rate (MCR) were measured at 30 s intervals using the Q-CPR review software. Results. The MCD changed significantly over time (0-30 s, 41.9-44.7 mm; 30-60 s, 40.4-43.6 mm; 60-90 s, 39.2-42.8 mm; 90-120 s, 38.6-42.3 mm; [95% CI], P=0.002). However, it did not decrease significantly between 60-90 s and 90-120 s (P=0.173). The total decrease in MCD was 2.9 mm over a 2 min period. The MCR did not change significantly over time (0-30 s, 108.6-118.9 /min; 30-60 s, 107.9-119.1 / min; 60-90 s, 107.7-119.3 /min; 90-120 s, 107.4-119.0 /min; P=0.800). Conclusions. Although the MCD changed significantly over a 2 min period, it did not decrease significantly after 90 s during performance of MOHCC. The MOHCC might be considered when the one-handed chest compression (OHCC) is selected as a chest compression method for cardiac arrest in small children.